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American Journal of Epidemiology Vol. 147, No. 1: 69-73
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Nationwide Oral Poliovirus Vaccination Campaign and the Incidence of Guillain-Barré Syndrome

Esko Kinnunen1,, Outi Junttila1, Jari Haukka2 and Tapani Hovi2

1Department of Neurology, Hyvinkää Hospital Hyvinkää, Finland
2National Public Health Institute Helsinki, Finland

Reprint requests to Dr. Esko Kinnunen, Department of Neurology, Hyvinkää Hospital, Sairaalankatu 1, 05850 Hyvinkää Finland

A retrospective analysis of the incidence of Guillain-Barré syndrome (GBS) in Finland in 1981–1986 was carried out by careful examination of medical records identified from nationwide Hospital Discharge Register data based on a mean total population of 5 million people. Records from 247 patients fulfilled the accepted criteria of GBS corresponding to a mean annual incidence of 0.82 per 100,000 population. Monthly rates showed an increased incidence of GBS in March 1985, following by a few weeks the onset of the nationwide oral poliovirus vaccine campaign and partly overlapping it. Analysis of the time series in depth suggested, however, that a change point in the occurrence of GBS had already taken place before the oral pollovirus vaccine campaign. Widespread circulation of wild-type 3 poliovirus in the population immediately preceded the oral poliovirus vaccine campaign and the peak occurrence of GBS. These results demonstrate a temporal association between poliovirus infection, caused by either wild virus or live attenuated vaccine, and an episode of increased occurrence of GBS, but they cannot prove the suspected cause-effect relation between GBS and oral poliovirus vaccine administration.

poliovirus vaccine, oral; polyradiculoneuritis; vaccination


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